Ask your AMA Guide questions to Dr. Chris Brigham. Christopher R. Brigham, MD is recognized as the nation's leading expert, author, and trainer on the Guides (www.impairment.com). We have expanded this category to include other rating questions under both new and old schedules.

DOI: 04/16/08Dx: rght wrist ganglion cystROM: All NormalPain is present with resisted palmar flexion. No other pain documented. No WPI apparently per pages 506-507. Can this be rated per Ch. 18? There is no questionnaire like shown on Table 18-4 attached to the MMI report.

Full assessment of pain by questionnaire is not necessary unless Dr. states pain is significant or severe - otherwise one can just add up to 3% with explaination of how the pain is greater than would be expected or not included in rating such as when rating based on ROM. However, there must be a ratable condition to "add-on" the pain. See legacy forum topic "Chapter 18 questions."

Alternatively your scenario may be rated using Section 2.5g, page 20 - when there is impaired functionality, but no "ratable" based on the arguement that IW has not returned to their previous status of good health.

2.5g talks about diseases in remission. And it says may increase the impairment by a small percentage. There is no impairment to increase. It is always debatable if a patient has regained the previous status of normal good health. In Cali I would lose the 3%. All it does is make extra work for everyone.